Journal of Bone and Joint Infection最新文献

筛选
英文 中文
Mortality, functional outcomes and quality of life after hip fractures complicated by infection: a case control study. 髋部骨折并发感染后的死亡率、功能结局和生活质量:一项病例对照研究
Journal of Bone and Joint Infection Pub Date : 2021-09-23 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-347-2021
Antonios A Koutalos, Christos Baltas, Vasileios Akrivos, Christina Arnaoutoglou, Konstantinos N Malizos
{"title":"Mortality, functional outcomes and quality of life after hip fractures complicated by infection: a case control study.","authors":"Antonios A Koutalos,&nbsp;Christos Baltas,&nbsp;Vasileios Akrivos,&nbsp;Christina Arnaoutoglou,&nbsp;Konstantinos N Malizos","doi":"10.5194/jbji-6-347-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-347-2021","url":null,"abstract":"<p><p><b>Introduction</b>: Infection is a detrimental complication of operatively treated hip fractures. The objective of this retrospective case-control study was to evaluate the mortality, the physical function and the quality of life of hip fractures complicated with infection and determine risk factors for deep infection in hip fractures. <b>Patients and methods</b>: All patients with hip fractures (31A and 31B OTA/AO) that were operatively managed over a 10-year period that subsequently developed deep infection were included in the study. Thirty-nine patients met the inclusion criteria. These patients were compared with a matched control group of 198 patients without infection. Minimum follow-up was 1 year. Mortality, Barthel index score, EQ-5D-5L, Parker mobility score and visual analogue scale (VAS) pain score were compared between groups. <b>Results</b>: Mortality at 1 month was 20.5 % and 43 % at 1 year. Half of the infections were acute and 28 % were polymicrobial. Mortality was greater in the infection group (43 % vs. 16.5 %, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.0014</mn></mrow> </math> ), and Barthel index was inferior in the infection group (14 vs. 18, <math><mrow><mi>p</mi> <mo><</mo> <mn>0.0017</mn></mrow> </math> ) compared to control group. Logistic regression analysis revealed that time from admission to surgery was a negative factor that predisposed to infection. <b>Conclusions</b>: Patients complicated with infection after a hip fracture have higher mortality and inferior functional results. Delay from admission to surgery predisposes to infection.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 8","pages":"347-354"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39490602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Left hand extensor tenosynovitis due to Histoplasma capsulatum complicated by immune reconstitution inflammatory syndrome. 包膜组织浆体并发免疫重建炎性综合征的左手伸肌腱鞘炎。
Journal of Bone and Joint Infection Pub Date : 2021-09-23 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-355-2021
Talha Riaz, Mark Collins, Mark Enzler, Marco Rizzo, Audrey N Schuetz, Julia S Lehman, Douglas Osmon, Irene G Sia
{"title":"Left hand extensor tenosynovitis due to <i>Histoplasma capsulatum</i> complicated by immune reconstitution inflammatory syndrome.","authors":"Talha Riaz,&nbsp;Mark Collins,&nbsp;Mark Enzler,&nbsp;Marco Rizzo,&nbsp;Audrey N Schuetz,&nbsp;Julia S Lehman,&nbsp;Douglas Osmon,&nbsp;Irene G Sia","doi":"10.5194/jbji-6-355-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-355-2021","url":null,"abstract":"<p><p>We describe a case of left hand extensor tenosynovitis due to histoplasmosis in a patient with dermatomyositis on chronic immunosuppression. Treatment involved surgical debridement and antifungal therapy. The patient experienced paradoxical worsening of tenosynovial inflammation during de-augmentation of immunosuppression felt to be immune reconstitution inflammatory syndrome.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 8","pages":"355-361"},"PeriodicalIF":0.0,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8485840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39490604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cost of off-label antibiotic therapy for bone and joint infections: a 6-year prospective monocentric observational cohort study in a referral centre for management of complex osteo-articular infections. 骨和关节感染非适应症抗生素治疗的成本:一项在复杂骨关节感染管理转诊中心进行的6年前瞻性单中心观察队列研究。
Journal of Bone and Joint Infection Pub Date : 2021-09-07 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-337-2021
Truong-Thanh Pham, Eugénie Mabrut, Philippe Cochard, Paul Chardon, Hassan Serrier, Florent Valour, Laure Huot, Michel Tod, Gilles Leboucher, Christian Chidiac, Tristan Ferry
{"title":"Cost of off-label antibiotic therapy for bone and joint infections: a 6-year prospective monocentric observational cohort study in a referral centre for management of complex osteo-articular infections.","authors":"Truong-Thanh Pham,&nbsp;Eugénie Mabrut,&nbsp;Philippe Cochard,&nbsp;Paul Chardon,&nbsp;Hassan Serrier,&nbsp;Florent Valour,&nbsp;Laure Huot,&nbsp;Michel Tod,&nbsp;Gilles Leboucher,&nbsp;Christian Chidiac,&nbsp;Tristan Ferry","doi":"10.5194/jbji-6-337-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-337-2021","url":null,"abstract":"<p><p><b>Introduction</b>: Costs related to bone and joint infection (BJI) management are increasing worldwide, particularly due to the growing use of off-label antibiotics that are expensive treatments (ETs), in conjunction with increasing incidence of multi-drug-resistant pathogens. The aim of this study was to evaluate the whole costs related to these treatments during the patient route, including those attributed to the rehabilitation centre (RC) stay in one regional referral centre in France. The total annual cost of ETs for managing complex BJIs in France was then estimated. <b>Material and methods</b>: A prospective monocentric observational study was conducted from 2014 to 2019 in a referral centre for BJI management (CRIOAc - Centre de Référence des Infections OstéoArticulaires complexes). Costs related to expensive treatments (\"old\" ETs, i.e. ceftaroline, ertapenem, daptomycin, colistin, tigecycline, and linezolid and \"new\" ETs, defined as those used since 2017, including ceftobiprole, ceftazidime-avibactam, ceftolozane-tazobactam, tedizolid, and dalbavancin) were prospectively recorded. In all cases, the use of these ETs was validated during multidisciplinary meetings. <b>Results</b>: Of the 3219 patients treated, 1682 (52.3 %) received at least one ET, and 21.5 % of patients who received ET were managed in RCs. The overall cost of ETs remained high but stable (EUR 1 033 610 in 2014; EUR 1 129 862 in 2019), despite the increase of patients treated by ETs (from 182 in 2014 to 512 in 2019) and in the cumulative days of treatment (9739 to 16 191 d). Daptomycin was the most prescribed molecule (46.2 % of patients in 2014 and 56.8 % in 2019, with 53.8 % overall), but its cost has decreased since this molecule was genericized in 2018; the same trend was observed for linezolid. Thus, costs for old ETs decreased overall, from EUR 1 033 610 in 2014 to EUR 604 997 in 2019, but global costs remained stable due to new ET utilization accounting for 46.5 % of overall costs in 2019. Tedizolid, used as suppressive antimicrobial therapy, represented 77.5 % of total new ET costs. In our centre, dalbavancin was never used. The cost paid by RCs for ETs and the duration of ET remained stable overall between 2016 and 2019. <b>Conclusions</b>: A high consumption of off-label ET is required to treat patients with BJIs in a CRIOAc, and the consequence is a high cost of antimicrobial therapy for these patients, estimated to be almost EUR 10 million in France annually. Costs associated with ET utilization remained stable over the years. On the one hand, the introduction of the generic drugs of daptomycin and linezolid has significantly decreased the share of old ETs, but, on the other hand, the need for new ETs to treat infections associated with more resistant pathogens has not led to decrease in the overall costs. A drastic price reduction of generic drugs is essential to limit the costs associated with more complex BJIs.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 8","pages":"337-346"},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39409714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Timing of debridement, antibiotics, and implant retention (DAIR) for early post-surgical hip and knee prosthetic joint infection (PJI) does not affect 1-year re-revision rates: data from the Dutch Arthroplasty Register. 来自荷兰关节置换术登记的数据:术后早期髋关节和膝关节假体感染(PJI)的清创、抗生素和植入物保留(DAIR)的时机不影响1年的再翻修率。
Journal of Bone and Joint Infection Pub Date : 2021-09-03 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-329-2021
Barry van der Ende, Jakob van Oldenrijk, Max Reijman, Peter D Croughs, Liza N van Steenbergen, Jan A N Verhaar, P Koen Bos
{"title":"Timing of debridement, antibiotics, and implant retention (DAIR) for early post-surgical hip and knee prosthetic joint infection (PJI) does not affect 1-year re-revision rates: data from the Dutch Arthroplasty Register.","authors":"Barry van der Ende,&nbsp;Jakob van Oldenrijk,&nbsp;Max Reijman,&nbsp;Peter D Croughs,&nbsp;Liza N van Steenbergen,&nbsp;Jan A N Verhaar,&nbsp;P Koen Bos","doi":"10.5194/jbji-6-329-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-329-2021","url":null,"abstract":"<p><p>Debridement, antibiotics, and implant retention (DAIR) is a procedure to treat a periprosthetic joint infection (PJI) after total hip arthroplasty (THA) or total knee arthroplasty (TKA). The timing between the primary procedure and the DAIR is likely a determinant for its successful outcome. However, the optimal timing of a DAIR and the chance of success still remain unclear. We aimed to assess the risk of re-revision within 1 year after a DAIR procedure and to evaluate the timing of the DAIR in primary THA and TKA. We used data from the Dutch Arthroplasty Register (LROI) and selected all primary THA and TKA in the period 2007-2016 which underwent a DAIR within 12 weeks after primary procedure. A DAIR was defined as a revision for infection in which only modular parts were exchanged. A DAIR was defined as successful if not followed by a re-revision within 1 year after DAIR; 207 DAIRs were performed <math><mrow><mo><</mo> <mn>4</mn></mrow> </math>  weeks after THA, of which 16 (8 %) received a complete revision within 1 year. DAIR procedures performed between 4 and 12 weeks ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>98</mn></mrow> </math> ) had a failure rate of 9 % ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>9</mn></mrow> </math> ). After TKA 126 DAIRs were performed in less than <math><mn>4</mn></math>  weeks, of which 11 (9 %) received a complete revision within 1 year; 83 DAIRs were performed between 4 and 12 weeks, of which 14 (17 %) were revised. There was no significant difference in 1-year re-revision rate after a DAIR procedure by timing of the DAIR procedure for total hip and knee arthroplasty based on Dutch registry data.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 8","pages":"329-336"},"PeriodicalIF":0.0,"publicationDate":"2021-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39409713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Systematic review of risk prediction studies in bone and joint infection: are modifiable prognostic factors useful in predicting recurrence? 骨与关节感染风险预测研究的系统回顾:可改变的预后因素对预测复发有用吗?
Journal of Bone and Joint Infection Pub Date : 2021-07-08 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-257-2021
Maria Dudareva, Andrew Hotchen, Martin A McNally, Jamie Hartmann-Boyce, Matthew Scarborough, Gary Collins
{"title":"Systematic review of risk prediction studies in bone and joint infection: are modifiable prognostic factors useful in predicting recurrence?","authors":"Maria Dudareva, Andrew Hotchen, Martin A McNally, Jamie Hartmann-Boyce, Matthew Scarborough, Gary Collins","doi":"10.5194/jbji-6-257-2021","DOIUrl":"10.5194/jbji-6-257-2021","url":null,"abstract":"<p><p><b>Background</b>: Classification systems for orthopaedic infection include patient health status, but there is no consensus about which comorbidities affect prognosis. Modifiable factors including substance use, glycaemic control, malnutrition and obesity may predict post-operative recovery from infection. <b>Aim</b>: This systematic review aimed (1) to critically appraise clinical prediction models for individual prognosis following surgical treatment for orthopaedic infection where an implant is not retained; (2) to understand the usefulness of modifiable prognostic factors for predicting treatment success. <b>Methods</b>: EMBASE and MEDLINE databases were searched for clinical prediction and prognostic studies in adults with orthopaedic infections. Infection recurrence or re-infection after at least 6 months was the primary outcome. The estimated odds ratios for the primary outcome in participants with modifiable prognostic factors were extracted and the direction of the effect reported. <b>Results</b>: Thirty-five retrospective prognostic cohort studies of 92 693 patients were included, of which two reported clinical prediction models. No studies were at low risk of bias, and no externally validated prediction models were identified. Most focused on prosthetic joint infection. A positive association was reported between body mass index and infection recurrence in 19 of 22 studies, similarly in 8 of 14 studies reporting smoking history and 3 of 4 studies reporting alcohol intake. Glycaemic control and malnutrition were rarely considered. <b>Conclusion</b>: Modifiable aspects of patient health appear to predict outcomes after surgery for orthopaedic infection. There is a need to understand which factors may have a causal effect. Development and validation of clinical prediction models that include participant health status will facilitate treatment decisions for orthopaedic infections.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 7","pages":"257-271"},"PeriodicalIF":0.0,"publicationDate":"2021-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9518173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Extensive skin necrosis after periprosthetic knee infection: a case that highlights the possibility of complications induced by low-molecular-weight heparin. 膝关节假体周围感染后广泛皮肤坏死:一例强调低分子肝素引起并发症的可能性。
Journal of Bone and Joint Infection Pub Date : 2021-06-28 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-235-2021
Hélder Fonte, André Carvalho, João Rosa, Cláudia Pereira, Alexandre Pereira, Ricardo Sousa, Further Members Of The Porto Bone And Joint Infection Unit
{"title":"Extensive skin necrosis after periprosthetic knee infection: a case that highlights the possibility of complications induced by low-molecular-weight heparin.","authors":"Hélder Fonte,&nbsp;André Carvalho,&nbsp;João Rosa,&nbsp;Cláudia Pereira,&nbsp;Alexandre Pereira,&nbsp;Ricardo Sousa,&nbsp;Further Members Of The Porto Bone And Joint Infection Unit","doi":"10.5194/jbji-6-235-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-235-2021","url":null,"abstract":"<p><p>We describe a case of a patient with atrial fibrillation, anticoagulated with dabigatran, that developed severe knee skin necrosis in the setting of an acute periprosthetic knee infection, after initiating low-molecular-weight heparin. A wide range of etiology hypotheses was discussed within a multidisciplinary team. The complex approach consisted of treating the underlying infection, multiple types of soft-tissue management, and stopping enoxaparin.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"235-240"},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39162856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Acute or chronic periprosthetic joint infection? Using the ESR ∕ CRP ratio to aid in determining the acuity of periprosthetic joint infections. 急性或慢性假体周围关节感染?使用ESR / CRP比值帮助确定假体周围关节感染的敏锐度。
Journal of Bone and Joint Infection Pub Date : 2021-06-08 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-229-2021
Zachary K Christopher, Kade S McQuivey, David G Deckey, Jack Haglin, Mark J Spangehl, Joshua S Bingham
{"title":"Acute or chronic periprosthetic joint infection? Using the ESR ∕ CRP ratio to aid in determining the acuity of periprosthetic joint infections.","authors":"Zachary K Christopher,&nbsp;Kade S McQuivey,&nbsp;David G Deckey,&nbsp;Jack Haglin,&nbsp;Mark J Spangehl,&nbsp;Joshua S Bingham","doi":"10.5194/jbji-6-229-2021","DOIUrl":"10.5194/jbji-6-229-2021","url":null,"abstract":"<p><p><b>Introduction</b>: The gold standard for determining the duration of periprosthetic joint infection (PJI) is a thorough history. Currently, there are no well-defined objective criteria to determine the duration of PJI, and little evidence exists regarding the ratio between ESR (mm/h) and CRP (mg/L) in joint arthroplasty. This study suggests the ESR  <math><mo>/</mo></math>  CRP ratio will help differentiate acute from chronic PJI. <b>Methods</b>: Retrospective review of patients with PJI was performed. Inclusion criteria: patients <math><mrow><mo>></mo> <mn>18</mn></mrow> </math>  years old who underwent surgical revision for PJI and had documented ESR and CRP values. Subjects were divided into two groups: PJI for greater (chronic) or less than (acute) 4 weeks and the ESR  <math><mo>/</mo></math>  CRP ratio was compared between them. Receiver-operating characteristic (ROC) curves were evaluated to determine the utility of the ESR  <math><mo>/</mo></math>  CRP ratio in characterizing the duration of PJI. <b>Results</b>: 147 patients were included in the study (81 acute and 66 chronic). The mean ESR  <math><mo>/</mo></math>  CRP ratio in acute patients was 0.48 compared to 2.87 in chronic patients ( <math><mrow><mi>p</mi> <mo><</mo> <mn>0.001</mn></mrow> </math> ). The ESR  <math><mo>/</mo></math>  CRP ROC curve demonstrated an excellent area under the curve (AUC) of 0.899. The ideal cutoff value was 0.96 for ESR  <math><mo>/</mo></math>  CRP to predict a chronic ( <math><mrow><mo>></mo> <mn>0.96</mn></mrow> </math> ) vs. acute ( <math><mrow><mo><</mo> <mn>0.96</mn></mrow> </math> ) PJI. The sensitivity at this value was 0.74 (95 % CI 0.62-0.83) and the specificity was 0.90 (95 % CI 0.81-0.94). <b>Conclusions</b>: The ESR  <math><mo>/</mo></math>  CRP ratio may help determine the duration of PJI in uncertain cases. This metric may give arthroplasty surgeons more confidence in defining the duration of the PJI and therefore aid in treatment selection.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"229-234"},"PeriodicalIF":0.0,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between Cutibacterium acnes infections and uncemented prostheses? 2012年至2018年瑞典一家地区医院髋关节假体周围感染:痤疮表皮杆菌感染与未胶结假体之间是否存在关系?
Journal of Bone and Joint Infection Pub Date : 2021-06-04 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-219-2021
Urban Hedlundh, Michail Zacharatos, Jonas Magnusson, Magnus Gottlander, Johanna Karlsson
{"title":"Periprosthetic hip infections in a Swedish regional hospital between 2012 and 2018: is there a relationship between <i>Cutibacterium acnes</i> infections and uncemented prostheses?","authors":"Urban Hedlundh,&nbsp;Michail Zacharatos,&nbsp;Jonas Magnusson,&nbsp;Magnus Gottlander,&nbsp;Johanna Karlsson","doi":"10.5194/jbji-6-219-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-219-2021","url":null,"abstract":"<p><p>The purpose of this study was to evaluate patients requiring in-patient care due to a periprosthetic joint infection (PJI), with respect to bacterial agents, surgical treatment, antibiotics, and outcome. We retrospectively identified all infected total hip arthroplasties (THAs) in a Swedish regional hospital during a 7-year period (2012-2018) and reviewed medical records and microbiological data. A total of 89 infected THAs in 87 patients were identified. Standardized treatment with debridement with retention of the implant and antibiotics (DAIR) was initially performed in 53 cases (60 %), one or two stage revisions in 33 cases (37 %), and an immediate Girdlestone in 3 cases (3 %). Infection eradication was seen in 77 PJIs (87 %) in addition to six patients (7 %) ending up with a permanent but uninfected Girdlestone. All six patients with manifest failures were infected with <i>Staphylococcus aureus</i>, two of which were also polymicrobial. <i>Cutibacterium acnes</i> was found in 18 of 89 patients (16 %) distributed in 15 uncemented implants but only in 3 hybrids and cemented arthroplasties, while remaining pathogens were equally distributed in uncemented THAs ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>31</mn></mrow> </math> ) and THAs with at least one cemented component ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>40</mn></mrow> </math> ; <math><mrow><mi>p</mi> <mo>=</mo> <mn>0.003</mn></mrow> </math> ). Eradication was achieved in all 18 patients when <i>Cutibacterium acnes</i> was the only culture ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>14</mn></mrow> </math> ) or clearly dominant among positive cultures ( <math><mrow><mi>n</mi> <mo>=</mo> <mn>4</mn></mrow> </math> ). DAIR was successful in selected postoperative infections up to 6 months after hip replacement. <i>Cutibacterium acnes</i> infections in hip arthroplasty may be underdiagnosed. Cemented components in THAs seem to protect from colonization with <i>Cutibacterium acnes</i>.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"219-228"},"PeriodicalIF":0.0,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement. 软组织厚度x线测量:评估全髋关节置换术中急性假体周围关节感染风险的标志。
Journal of Bone and Joint Infection Pub Date : 2021-06-04 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-211-2021
Laura Rey Fernández, Francesc Angles Crespo, Silvia María Miguela Álvarez, Martí Carles Bernaus-Johnson, Agustí Bartra Ylla, Lluís Font-Vizcarra
{"title":"Soft-tissue thickness radiographic measurement: a marker to evaluate acute periprosthetic joint infection risk in total hip replacement.","authors":"Laura Rey Fernández,&nbsp;Francesc Angles Crespo,&nbsp;Silvia María Miguela Álvarez,&nbsp;Martí Carles Bernaus-Johnson,&nbsp;Agustí Bartra Ylla,&nbsp;Lluís Font-Vizcarra","doi":"10.5194/jbji-6-211-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-211-2021","url":null,"abstract":"<p><p>The objective of our study was to evaluate the association between acute periprosthetic joint infection (APJI) and radiographic measurement of soft-tissue thickness in elective total hip replacement surgery. A case-control study was conducted to compare the soft-tissue thickness radiographic measurement (SRM) at the hip in patients diagnosed with APJI based on Tsukayama et al. (2003) criteria after total hip replacement with patients that were not infected, at a single institution from 2013 to 2019. To minimize selection bias, each case was matched with two controls using the following methodology: patients of the same sex, with an age variation of <math><mo>±</mo></math> 5 years, and nearest in surgery date to the cases were selected. All postoperative radiographs were performed in the first 24 h after total hip arthroplasty (THA) surgery as it is protocolized in our institution. Soft-tissue thickness radiographic measurement was defined as the distance from the tip of the greater trochanter to the skin following a perpendicular line to the femoral diaphysis in postoperative anteroposterior hip radiographs. In total, 78 patients were included (26 cases and 52 controls). The SRM median of the cases was 76.19 mm (SD: 26.518) and 53.5 mm (SD: 20.47) in controls. A multivariate logistic regression model showed an independent association between APJI and SRM (odds ratio (OR)  <math><mo>=</mo></math>  1.033, 95 % confidence interval (CI) 1.007-1.059, <math><mrow><mi>p</mi> <mo>=</mo> <mn>0</mn></mrow> </math> .012). Patients with an SRM greater than 60 mm had a 7-fold increase in the odds of APJI (OR  <math><mo>=</mo></math>  7.295, 95 % CI  <math><mo>=</mo></math>  2.364-22.511, <math><mrow><mi>p</mi> <mo><</mo> <mn>0</mn></mrow> </math> .001). The results of our study suggest an association between large SRM at the hip and the risk of APJI in patients with primary total hip arthroplasty. SRM may be a helpful and easy tool for evaluating the risk of APJI before elective primary total hip replacement surgery.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"211-217"},"PeriodicalIF":0.0,"publicationDate":"2021-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8209611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39017110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
A rare case of invasive non-typeable Haemophilus influenzae spondylodiscitis and periprosthetic joint infection. 侵袭性不可分型流感嗜血杆菌脊柱椎间盘炎和假体周围关节感染的罕见病例。
Journal of Bone and Joint Infection Pub Date : 2021-06-02 eCollection Date: 2021-01-01 DOI: 10.5194/jbji-6-207-2021
Kevin Sermet, François Demaeght, Isabelle Alcaraz, Nathalie Viget, Julie Dauenhauer, Eric Senneville, Olivier Robineau
{"title":"A rare case of invasive non-typeable <i>Haemophilus influenzae</i> spondylodiscitis and periprosthetic joint infection.","authors":"Kevin Sermet,&nbsp;François Demaeght,&nbsp;Isabelle Alcaraz,&nbsp;Nathalie Viget,&nbsp;Julie Dauenhauer,&nbsp;Eric Senneville,&nbsp;Olivier Robineau","doi":"10.5194/jbji-6-207-2021","DOIUrl":"https://doi.org/10.5194/jbji-6-207-2021","url":null,"abstract":"<p><p>A non-typeable <i>Haemophilus influenzae</i> (NTHi) was responsible for an invasive infection including bacteremia, spondylodiscitis with epidural abscess, and periprosthetic hip infection in a 79-year-old woman, triggered by a superinfected ethmo-orbital mucocele. Surgical drainage and antibiotic therapy allowed recovery. PET-scan full cartography of NTHi infection dissemination enabled the discovery of spondylodiscitis. This rare cause of spondylodiscitis and periprosthetic joint infection suggests a complete work-up is unavoidable.</p>","PeriodicalId":15271,"journal":{"name":"Journal of Bone and Joint Infection","volume":"6 6","pages":"207-209"},"PeriodicalIF":0.0,"publicationDate":"2021-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39096935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信